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Tuesday, 17 December 2013

Forgive me father for I have sinned…

Although I am not a man of faith I have been shouldering some of my wife’s catholic guilt for a while and I have chosen the church of the Fuse blog to repent my sins. My shame for which I deeply wish to apologise for is that I was a fattist. I don’t mean this as a glib remark, I feel genuinely remorseful and embarrassed.

As with many –isms their spread is the result of mistruths and manipulation. On a search for the aetiology of my own previous held prejudicial views I realised that they were born out of a combined biblical belief in “the energy balance” and “a calorie is a calorie is a calorie”. The zeal to which many of us hold these two principals up as beyond reproach has blinded us to the wealth of research into the role of leptin, insulin and satiety in response to each of the macronutrients, the thermic effect of food and the overwhelming influence of our genetics in our predisposition to gaining weight. As a result the failure of this regulatory process is not blamed rightly on the foods we eat but the twin sins of greed and sloth.

I have always been thin, but instead of viewing this fortune as the luck of the genetic hand that I was dealt I smugly believed that it was down to my excellent constitution. But arrogance is the preserve of the misinformed and I was content in my protective shield of ignorance and happy to vilify those overweight as lacking in that intangible latent variable of ‘will power’.

This shift of focus from a physiological to a behavioural discipline has not only resulted in a generally accepted persecution, and in many cases resultant self-loathing in overweight individuals, but it also plays into the hands of the food companies that got us there in the first place. A blatant disregard for some quality science has led us down the path of poor food regulation and as a result we have become addicted to the most toxic dietary substance, that of sugar and we are left fighting an almost unwinnable battle.

These companies are smart. They haven’t just been one small step ahead of us but one giant leap. They were acutely aware of physiologist John Yudkin’s work linking sugar consumption to heart disease and started a campaign not only to discredit him but also crucially buy them time. The intervening years have bought these companies great wealth and substantial lobbying power. But finally, it seems that the sweet tide is starting to turn and there is greater acceptance that sugar is the silent assassin in our diets. Unfortunately our love of their products runs deep, this combined with their formidable defence force has meant that any meaningful change will be incredibly difficult, as demonstrated by the New York soda ban. Therefore to win this war over the health of our hearts we must present a strong, clear message to win over people’s minds.

As much as the prejudices are born out of an oversimplification the excuse for a fix are blamed on an over-complication. Many a toothless smile would have beamed across the boardroom of Sugary Drinks Ltd. on the release of the Foresight obesity systems map. As this incomprehensible, impenetrable and unvalidated model was held up as highlighting the innumerable potential pathways to obesity. So instead of being the Ace of Spades in the most wanted list they quietly disappear into the ether as one minion amongst millions. As a result there are now too many competing interests in the quest to tackle the obesity epidemic and we have to filter the wheat from the chaff, or more appropriately the raw sugar from the harvested cane. There should be an increased focus on the metabolic effects of the macronutrients so that we have the full backing of the scientific community when we next have these companies backed into a corner so that we are able to disarm them of their twin-barrelled attack of ‘calories’ and ‘complexity’.

A further symptom of our collective inability to target the sugar-daddies is the perpetuation of the futile debate of whether obesity should be classified as a disease. All this does is to further stigmatise those that are suffering. Now whatever your personal opinion the clear fact remains that those of us that are clinically defined as obese are significantly at greater risk to a huge number of illnesses many of which are fatal. But instead of showing compassion a quick glance to the magazine rack would imply that we are happier in the role of Mr Nasty on a real-world talent show judged exclusively on weight status.

The sensation of hunger is paramount to our survival, but there is a catastrophic failure of our current diet to satiate and provide the appropriate nutrition for a sustainable lifestyle. But instead of pointing the finger at the food, the individual and their supposed ‘weak will’ has become the object of our ire. The shocking fact is not that one third of all adults are obese but how some still remain thin in an environment so predisposed to making us fat.

Feelings of distain towards the obese might provide you with some fleeting sense of misplaced superiority but crucially they contribute nothing to the solution. Chastising the victim of any given disease is never the basis to formulate effective public health policy. Ridiculing those of us that are overweight will not reverse the trend but just serve to elevate the level of infighting while those pumping the noxious substances into our bodies continue laughing all the way to the bank.

How strange that when I stopped eating shit and started exercising regularly I lost 70 lbs. Turns out I needn't have bothered, because my deeply unhealthy weight wasn't my fault, it was "MUH GENETICS!" and the fact that I chose to eat chocolate rather than fruit was the fault of Big Gastro.

Here I went to all the hassle of taking responsibility for my own decisions, realising that my life is my own, and internalising my locus of control.

Instead I should have just accepted that my weight and health were totally out of my control.

And heaven forbid that I should look down upon super-morbidly obese people who refuse to even attempt to acknowledge that nobody's force feeding them or preventing them at gunpoint from occasionaly going for a long walk or lifting some weights.

And how silly of me for thinking that mass can't just magically appear on the hunan body in the form of fat without said human body a) consuming it and b) failing to burn it.

You really educated me with this. Thanks. I'll go have a KFC now, because my weight, health and body-composition isn't within my own control anyway, so I may as well binge on grease and sodium.

Custador, thank you for reading the post and moreover for taking the time to comment. I believe your strong views echo many, if not the majority, on the issues raised regarding obesity. I am not so pompous that I wish to “educate” but I would like to offer further thoughts and an alternative view to why I no longer agree with your beliefs.

First I would like to congratulate you on the incredible achievement of losing so much weight and I wish you well in the bigger battle you face in keeping the weight off as the overwhelming evidence suggests that this will be the tougher challenge.

You’re right to point out that genetics cannot be blamed, but equally they cannot be ignored. Twin studies clearly demonstrate the huge variability in one’s capacity to put on weight and therefore generic, universal guidance as to what one can eat is dated and dangerous especially if it’s advocating that the effects of a can of soda can be balanced out by doing some ironing.

Your personal strategy of “taking responsibility for your own decisions” has worked and I by no means wish to detract from this but I am advocating that there are others that should also accept their role in the epidemic. Your motivation for weight loss will have come from one of two sources; health concerns over the potentially fatal comorbidities or a high degree of self-hatred regarding body image and I suspect it is the latter due to your lack of compassion for those suffering from morbid obesity and who most likely face an early death.

No one actively chooses to be overweight and no animal in their natural habitat, bar those entering hibernation, carries excess weight, therefore logic dictates that our environment is imparting a great influence.

As I did, I suggest you ask yourself some tough questions. When you were eating, what you term as “shit”, you evidently knew it was doing you harm, therefore why did you continue to do so? What were the properties of the food that made it difficult for you to stop? If it was so blinding obvious to you, why did you have to gain 70 lbs to realise this self-evident fact?

I would contend that sugar is highly addictive and highly conducive to weight gain. Food companies know this and they are manipulative both in the manufacture of their products to optimise such properties and also how they are marketed. If you were willing I would love for you to do a one day experiment in which you count how many times you encounter an advert for “shit” food, be it on the internet, TV or while you are out taking exercise and compare it to how often you see a promotion of healthy food. Think how a drug addict might respond to the equivalent level of marketing of illicit narcotics.

You raise another interesting point regarding why someone who is morbidly obese might choose not to go “for a long walk or lift some weights”. I would counter by asking you if since your loss of 70 lbs do you feel that you have more or less energy? Undoubtedly you now feel greatly more energetic and hence our presumed understanding of causation is wrong; people are not fat because they are lazy, they are lazy because they are fat! They are trapped in a cycle, which is incredibly difficult to break and there are powerful stakeholders that are incredibly happy with the status quo.

Now at what point do you start to blame the individual? There is strong evidence that shows that if you’re overweight as a child there is a very high chance you will be overweight as an adult, therefore taking your standpoint should we “look down upon” obese children, tell them to “take responsibility” for their weight status? Clearly unethical and unfair as we know they are highly dependent on the support of their family and others, so if not them, should we focus on the parents? This assumes a position that parents are knowingly feeding food that is killing their children, which defies any understanding of human nature. For me, a more feasible argument would contend that we know obesity is strongly associated to lower socio-economic groups and for many there is a struggle to afford sufficient nutrition for the family and the cheapest and most accessible sources of food tend to be those that are most weight gain inducing. In addition if you had read the number of studies that I have you would be surprised and amazed and hopefully disappointed and upset at many people’s lack of knowledge regarding good nutrition, which must be rectified by educational bodies.

I understand that we have a fundament differing of opinion; self Vs society, but I suggest that you look a little deeper as to how the discussion has been framed and arguments formed. But back to the final point of the post, surely you must want to see an end to this epidemic? If not out of compassion for your fellow man, but to curtail the billions in taxes that are spent in both preventative measures and treatment of the sick.

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